1) "If I have a facelift will I look pulled or too tight?"
Before and After Photos
Will I still look like "me" after cosmetic surgery? Many of our patients report that, upon return to work and routine daily activities, friends and acquaintances make the following remarks: "Gee you look great. Did you change your hairstyle?" or "Have you been on vacation?" Retaining your uniqueness is the sign of a successful procedure. Although the change may be significant to you, it's not uncommon that friends and family don't really notice the specific changes unless patients request dramatic changes.
2) Yes, but I want to dramatically change the appearance of my face.
Before and After Photos
This is an excellent question because it leads to evaluating realistic expectations and, of course, can only be answered on an individual basis. For some patients who "want to look like someone else," this request can potentially raise a red flag to find out more about their motivation and self esteem. However, the patient in the before-and-after photograph knew from the time of own youth that her mother and aunts appeared older than their age. Her situation was one of genetics, and she knew no matter how well she cared for her skin and body, the signs of premature aging were all around her. As a result, she wanted a dramatic change with her expectations and motivations well thought out and very realistic.
One sign of a good board certified facial plastic surgeon is one who can tell the difference between realistic and unrealistic expectations and one who will be truthful about meeting each patient's desires. Our biggest referral source is from satisfied patients - ones who have had realistic expectations and were satisfied with results.
3) Do you tighten the muscles?
We're always glad to hear this question because it shows that patients are doing their homework. Yes, the relaxed muscles are "tightened" under the skin and the excess skin is removed. Tightening the muscles eliminates the "turkey wattle" (that floppy thing that hangs down on a turkey's neck) and results in a more youthful appearance. Because of the elasticity of skin, if only the excess skin were removed, the benefits of a facelift would be very short-lived - about six to eight weeks. Successful facial reconstruction involves both muscles and skin.
4) How long will my facelift last?
As with facelifts, the longevity of the benefits is dependent on several factors. For patients who do not smoke, do not abuse the sun, are in good general health and have good genetics, a facelift can last upwards of 10 years. For patients who elect to abuse their skin and body, a facelift will only last up to five years. Don't forget - attention to your general health plays a significant roll in a younger appearance.
5) Will a facelift help the dark circles and bags under my eyes?
Before and After Photos
If you have dark circles and bags under your eyes, you are most likely hoping for the benefits of a blepharoplasty (eyelid tuck) which often uncovers hidden beauty of the eyes. A facelift may provide some improvement, however, it will not meet the expectations of most patients whose primary concern is the bags under or dark circles around the eyes. It is most common that patients with these two concerns, have a combination of procedures which may include facelift, blepharoplasty (eye tuck), skin resurfacing. Keep in mind that a facelift does not address the surface or textural changes (such as fine wrinkles) in the skin.
6) Do I need a chin implant?
Before and After Photos
It is not uncommon for patients who are learning about facelifts to gain an appreciation for the underlying principles of beauty, including symmetry and balance. One of the benefits of computer imaging is the ability for the surgeon to give you a good idea ahead of time about the overall balance of your face, including whether you are a candidate for a chin implant would look. If your chin appears balanced with the forehead and face, you do not need to consider a chin implant.
7) What about my droopy double chin and jowls?
Most patients undergo neck liposuction at the same time as facelift. This has several advantages. It allows us to use the fat in another area for cosmetic enhancement (such as for lip augmentation) while simultaneously reducing the bulky area around the neck. Removing the excess fat under the chin and neck results in a more defined neck line. Tightening the muscles as well as the skin eliminates jowling resulting in a more clearly defined jaw line.
8) Will a facelift get rid of all my wrinkles?
Before and After Photos
As we age, our skin looses its elasticity. A facelift is most often performed to "lift" and remove sagging skin and as a result eliminate some wrinkles. Some of the deepest lines (such as the frown lines between the eyes that are improved with a Brow Lift) may not completely resolve but they will be significantly improved. Further improvement can be achieved with <Skin Resurfacing> such as CO2 laser. Fillers such as Fat Injections can improve wrinkles and are particularly effective on laugh lines or smile lines. Patients who are not ready for surgery visit the Q- the Medical Spa at Lindsay House to consider Botox, collagen injection, microdermabrasion or several other conservative procedures - many of which can be performed on the lunch hour.
9) I had a facelift somewhere else and I don't like my result. Can you "fix" it?
It's not uncommon for patients who have previously had facelifts to be referred to the Lindsay House for revision surgery. Although patients may want immediate adjustments to the original facelift, patients should wait one full year before undergoing revision facelift.
First of all, final results of facelift are not evaluated until one full year postoperatively. It takes a year for postoperative swelling to subside and healing to be complete. Changes, however subtle, continue throughout the 12-month course following facelift. As time goes by, the face gradually looks different. Features refine as the swelling resolves. These refinements sometimes are enough for a result to be deemed acceptable.
A second consideration is scar formation. Revision facelift is challenging enough without battling through scar tissue that has not matured. Scar tissue is somewhat more compliant in the hands of the surgeon when it has been allowed to soften over time. Even after a year the presence of scar tissue makes revision surgery more complex.
If a surgeon recommends revision facelift at less than one year, at the very least obtain a second opinion. Give your facelift every possible opportunity to "settle" and refine before undergoing another surgery.
10) Why is a revision facelift more difficult than a first-time facelift?
Before and After Photos
Many reasons. First, after any surgery, scar formation creates a thick, tough layer that is more difficult to work with than original tissue. Second, the original location of (anatomical) landmarks have been altered. Third, the overall skill level required to perform a successful revision facelift is greater. Revision facelifts can take a little longer because of corrections that need to be made as a result of the initial surgery. It is best to provide a patient with a realistic picture of exactly what can be accomplished prior to undergoing another surgery. Revision facelifts have humbled even the most experienced facial plastic surgeon…and at the same time have been the most rewarding.
11) How much pain will I have?
Most patients who have facelift surgery say how surprised they are at how mild the discomfort is that they experience. Patients more typically complain of tightness from swelling or a pulling sensation under the chin. Understandably, after any surgical procedure, some discomfort can be expected. All patients are provided with prescriptions for pain medication. Patients sometimes use the prescription medication two to three days after surgery and then switch to Extra Strength Tylenol. It is uncommon for patients to report unmanageable pain after surgery.
12) Tell me about the numbness associated with a facelift.
Numbness, especially near the incision lines, is most noticeable in the immediate postoperative period. Many patients report resolution of numbness within about six weeks following facelift although patients are told to expect it to lasts up to three months.
13) Will I be awake during surgery?
Using IV sedation (medicine administered through an IV) and a local anesthetic (numbing medication administered in the operating room), patients are asleep during surgery. Patients do not hear or feel anything and are comfortable during the operation. Patients wake up very soon after the surgery is completed. Intravenous sedation is a type of anesthesia; therefore all patients must have a responsible adult to stay with them through the night following surgery. Patients may not drive for 24 hours after their procedure and this time may be longer, depending on the procedure.
14) Do I go home after cosmetic surgery?
Yes, most facelifts are done on an outpatient basis. Because you will go home after receiving sedation, you will need to make arrangements for a responsible adult to drive you home, to stay with you overnight and to drive you to our office for your first postoperative appointment. Your first appointment is usually early in the morning the day after surgery. Patients having surgery must stay in the immediate Rochester area overnight within 30 minutes of our East Avenue facility.
15) How long should I stay in Rochester following surgery?
Most patients stay in Rochester about seven to ten days following surgery. After that it's ok to fly or travel long distances.
16) I'm from out of town. Where can I stay overnight in Rochester?
Accommodations are comfortable and convenient for Lindsay House clients. The Strathallen, located "just down the street" provides upscale, affordable accommodations for Lindsay House visitors. For added convenience following ambulatory surgery, some patients elect to stay in our Carriage House, located adjacent to the Lindsay House. For guests without the benefit of family or friends in the Rochester area, our staff will be happy to assist you with arrangements for a smooth, restful experience following your procedures.
17) When can I go back to work?
Restrictions from work are generally two weeks for facelift surgery. Because initial surgery swelling may still be present, some patients take three weeks off to be safe.
18) When can I "work out?"
Aerobic activities should be avoided for three weeks following surgery. Any activity that potentially increases blood pressure will increase the amount of time it takes for postoperative swelling to resolve.
19) How long will bruising and swelling last?
Postoperative bruising and swelling begins to resolve at the end of the first week. Full resolution of bruising or swelling may take two to three weeks. However, you may camouflage bruises fairly easily at seven to ten days with concealer stick.
20) I really want to do this but I'm nervous. What if I get stressed?
It's ok to be nervous. (Frankly, we would be nervous if you were taking this step lightly!) One of the best ways to deal with nervousness is to see what other patients have gone through. Take a moment to look at Before and After Photos. Check out our board certifications in Selecting a Surgeon. Remember, an educated patient knows when and if the time is right to proceed.
FACELIFT PREOPERATIVE INSTRUCTIONS
1) What do I do to prepare for surgery?
Although the preparation for surgery is pretty simple, it is an essential element in a successful outcome. To prepare for surgery, a preoperative appointment will be scheduled with one of our experienced nurses. Read on if you would like to know more about the preparation and postoperative care involved with a facelift.
2) What happens at the preoperative appointment?
Many things! To name a few, you will meet with our nurses who review your health history, answer your questions, instruct you on how to prepare for surgery, provide prescriptions for use after surgery and tell you what to expect. Most of the instructions are listed here below. This list of questions, however, will not take the place of a preoperative visit, which is essential in determining a patient's understanding and readiness for surgery. We will be sure you are signing an informed consent.
3) What does informed consent mean?
Informed consent means you have an excellent understanding about the benefits of surgery as well as any risks, and all the preoperative and postoperative information. You are making an "informed" decision as to whether surgery is right for you.
4) What are the benefits and risks of a facelift?
As part of your initial consultation, your physician will review your expectations for surgery. At that time, he can provide a realistic picture of what surgery can and cannot accomplish. Depending on which procedures you are interested in, we will provide you with a list of any risks reported in the medical literature associated with all procedures you are considering. Although risks from cosmetic surgery are uncommon, every patient should be fully informed of any risk associated with surgery.
5) Where will my incisions be placed?See the illustration for placement of incisions in front of and behind the ears. Because incisions are placed in a natural skin crease, facelift incisions heal very well and most patients and family members will not notice them after a few weeks.
6) What if I have a history of bad scars?If you have pierced ears, the way you healed there is a good indication of how you will heal from facial plastic surgery. Scars on the rest of the body typically are not an indication for how patients heal following facial plastic surgery. At the time of your consultation, it's important to show your physician any previous scars that are of concern to you so he can give you a realistic assessment of your healing potential following facial plastic surgery.
7) What are some of the other things to do to prepare for surgery?
We review your health history and any daily medications you may be taking. Because tobacco abuse impedes wound healing, you will be asked to stop for two weeks before surgery and two weeks following surgery. Our nurses will be happy to discuss over-the-counter aids to help you with this.
8) What about my daily medications before surgery?
You will have a preoperative appointment well in advance of your surgery when our experienced staff will review all mediations with you. If you are on "blood thinners," you will be asked to stop them approximately one week prior to surgery. We also ask that you avoid certain over-the-counter medications. We will provide a "Medication List" for medications and supplements to avoid prior to surgery.
9) I take vitamins and supplements. Do I need to stop them before surgery?
Most vitamins and supplements have few side effects. However, there are some, such as vitamin E and ginkgo-biloba, that affect bleeding during surgery. Also, because there are now so many supplements available, we do not know how supplements interact with anesthesia. We will provide a "Medication List" for products to avoid before surgery.
10) Do I need any special prescriptions before surgery?
Most patients do not need any special prescriptions before surgery. Please let us know of any special medical concerns you may have. (We will address prescriptions needed after surgery below.) You will also be instructed not to eat or drink anything after midnight the night before surgery.
11) Why will I be asked not to eat or drink anything?
Anesthesia medications can cause stomach upset. The best way to prevent after effects from anesthesia will be to avoid food or drink from midnight the night before surgery. For patients with special concerns, such as a patient with diabetes, our nurses will be happy to address special arrangements with you ahead of time.
12) I'm concerned about my privacy?
During a recent independent study, confidentiality was found to be one of the advantages that attracted people most to Lindsay House. Because all consultations, office visits, surgical and nonsurgical experiences take place at the same address, the check-in process is pretty easy.
13) What happens when I check in for surgery?
Our nurses will help you get ready for surgery. You will have an IV and change into a gown. Please let our nurses know of any special needs you may have. Also, be assured that you have plenty of time for any last minute questions with your doctor.
14) Does someone have to stay at the Lindsay House while I have my surgery?
No one needs to stay at the Lindsay House during your surgery. However, you must have someone available by telephone at all times during your surgery.
15) What other instructions are there?
Glad you asked! See the postoperative instructions below.
FACELIFT POSTOPERATIVE INSTRUCTIONS
1) What does it feel like when I wake up from surgery?
Most patients report only mild to moderate discomfort associated with some tightness or pulling. This pulling sensation, most noticeable under the chin, subsides after about three weeks. We will make sure you are not nauseated or queasy. Our nurses will be right there with you as you wake up from surgery to give you special attention.
2) What do I look like when I wake up from surgery?
Following the procedure, you will have a soft head wrap around your head and under your chin. This helps minimize swelling. You will also have a tube with a ball on the end of it - called a drain - just behind each ear. We will teach you and your family how to empty these drains overnight. The drains and the head wrap will be removed in the office the following morning. An elastic (ace) bandage will be gently applied to minimize swelling. You may have some bruising, however, this typically is more pronounced 24-48 hours after the procedure.
3) Can I do anything to prevent bruising?
Most patents will have a little bruising. We can minimize bruising by using Arnica before and after the procedure. Arnica is a natural "herb" that helps prevent bruising.
4) Tell me more about the sutures.
At the first preoperative appointment the next morning following surgery, the drains and head wrap dressing is removed. The sutures near your ears will require some simple care. We will ask you to use a Q-tip to cleanse them with peroxide and apply an antibiotic ointment (polysporin/bacitracin) twice a day to keep the sutures soft. In four to five days, when the time arrives for suture removal, sutures that have been lubricated glide out easily.
5) When can I shower?
Other than the wound care mentioned, it is important to keep the sutures dry. It is very important that you take a shower and wash your hair the morning before coming in for suture removal on postoperative day four or five. Once we remove the sutures, steri-strips (butterflies) are applied and you will not be allowed to shower for about five more days. As long as you keep your head dry, you may bathe at any time following the procedure.
6) Will I need any special prescriptions following surgery?
Yes. Postoperative prescriptions are provided well in advance of surgery day so you arrive home completely prepared. Postoperative prescriptions and over-the-counter medications for facelift patients include the following
A) An antibiotic (Keflex/cephalexin) to take after surgery to prevent infection.
B) Pain medication (Vicodin/hydrocodone) to minimize any discomfort.
C) Ointment (polysporin/bacitracin)to place on the sutures.
D) As previously mentioned, over-the-counter Arnica to minimize bruising.
E) Vitamin C 1000 mg with food daily three times a day for one week following surgery to promote healing.
7) When do I start taking these prescriptions?
Patients take their pain medication as needed. The Arnica, antibiotic and swelling medications begin when you arrive home following surgery. Unless you are notified otherwise, resume all daily medications when you arrive home from surgery.
8) Are there any dietary restrictions following surgery?
No. Patients can eat whatever they want. Advance your diet from liquids (fruit juice, milk shakes with Carnation Instant Breakfast, etc.) to soft food (pudding, macaroni and cheese, mashed potatoes and gravy, oatmeal, pasta) to solids as tolerated. To prevent dehydration, please drink as much juices and nutritional fluid as possible.
9) When is my first postoperative appointment?
You will be asked to come to the Lindsay House the on the first day following facelift for removal of head wrap dressing and drains. You will need someone to drive you to this appointment.
10) Does it hurt to get the drains removed?
Most patients tell us that there is a momentary pulling or blunt sting when the drain is removed. It is described more as a discomfort than pain.
11) Are there any instructions about regular daily activities?
Sleep with head of the bed elevated or use two to three pillows for one week. Facial fullness, headache and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. Absolutely no bending, lifting or straining. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap.
12) When will I look normal?
You will be presentable at two to three weeks. You will look great at six weeks and even better at six months as things settle and expressions become more natural. At three weeks you know you are well on the way to recovery and most patients resume routine activities around two to three weeks following surgery. Final results are evaluated at one year.
13) How long does healing take?
Healing from facelift to evaluate the final result takes one full year. However, after three months, most patients have about 90% of their final result.
14) How can I learn more about facelifts?
Several ways. First, Contact Us or call 1-585-244-1000 for any specific questions. If our Patient Care Coordinator can't answer them, she will gladly forward them to the appropriate physician or staff member. Also, you can learn more about Selecting a Surgeon and what happens at Your Consultation appointment, or more about the training, experience and board certifications of our Surgeons & Staff here on our website. We can also suggest some other resources for you to explore.
Facelift Before & After Photos
Facelift Procedure Information